HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text (PDF) References Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): James A. Magovern John L. Pennock David B. Campbell William S. Pierce John A. Waldhausen Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Magovern, J. A. Articles by Waldhausen, J. A. Search for Related Content PubMed PubMed Citation Articles by Magovern, J. A. Articles by Waldhausen, J. A.

Ann Thorac Surg 1985;39:346-352
© 1985 The Society of Thoracic Surgeons

---

Articles

Risks of Mitral Valve Replacement and Mitral Valve Replacement with Coronary Artery Bypass

Division of Cardiothoracic Surgery, Department of Surgery, College of Medicine, The Pennsylvania State University and The Milton S. Hershey Medical Center, Hershey, PA

Accepted for publication July 10, 1984.

^* Address reprint requests to Dr. Pennock, Department of Surgery, College of Medicine, The Pennsylvania State University, Hershey, PA 17033

One hundred thirty consecutive patients who underwent mitral valve replacement (MVR) or MVR with coronary artery bypass grafting (CABG) using cold crystalloid cardioplegic solution were analyzed to determine operative mortality and risk factors. Twenty-eight patients had mitral stenosis (MS), 37 had mitral regurgitation (MR), 37 had mixed MS and MR, 23 had MR with coronary artery disease (CAD), and 5 had MS with CAD. Preoperative pulmonary artery pressure, pulmonary capillary wedge pressure, and cardiac index were not different among groups, but patients with MR and CAD had a significantly higher left ventricular end-diastolic pressure (LVEDP) and a significantly lower ejection fraction than other groups. Mortality was 7.1% for patients with MS, 5.4% for MR, 8.1% for mixed MS and MR, 0 for MS with CAD, and 21.7% for MR and CAD. Overall mortality was 9.2%.

Eleven patients had emergency operations for cardiogenic shock with a mortality of 45%. Nineteen additional patients in New York Heart Association (NYHA) Functional Class IV had MVR or MVR plus CABG with a mortality of 26%. Sixteen patients required intraaortic balloon pump assistance, and 9 survived. Four patients with MR and CAD required the left ventricular assist device, and 3 survived. Excluding patients who had emergency operations, overall mortality was 5.8%. Excluding patients who had emergency operations and patients in NYHA Functional Class IV, overall mortality was 2%. Factors associated with death were cardiogenic shock, NYHA Class IV, LVEDP greater than 15 mm Hg (16% mortality), and age greater than 60 years (15% mortality).

This article has been cited by other articles:

				M. Maganti, M. Badiwala, A. Sheikh, H. Scully, C. Feindel, T. E. David, and V. Rao Predictors of low cardiac output syndrome after isolated mitral valve surgery J. Thorac. Cardiovasc. Surg., October 1, 2010; 140(4): 790 - 796. [Abstract] [Full Text] [PDF]

				R. C. Gorman, J. H. Gorman III, and L. H. Edmunds Jr. Ischemic Mitral Regurgitation , January 1, 2003; 2(2003): 751 - 769. [Full Text]

				E. L. Hannan, M. J. Racz, R. H. Jones, J. P. Gold, T. J. Ryan, J.-P. Hafner, and O. W. Isom Predictors of mortality for patients undergoing cardiac valve replacements in New York State Ann. Thorac. Surg., October 1, 2000; 70(4): 1212 - 1218. [Abstract] [Full Text] [PDF]

				W.R. E. Jamieson, F. H. Edwards, M. Schwartz, J. W. Bero, R. E. Clark, and F. L. Grover Risk stratification for cardiac valve replacement. National Cardiac Surgery Database Ann. Thorac. Surg., April 1, 1999; 67(4): 943 - 951. [Abstract] [Full Text] [PDF]

				J. J. Vincens, D. Temizer, J. R. Post, L. H. Edmunds Jr, and H. C. Herrmann Long-term Outcome of Cardiac Surgery in Patients With Mitral Stenosis and Severe Pulmonary Hypertension Circulation, November 1, 1995; 92(9): 137 - 142. [Abstract] [Full Text]

				T. Mizutani, M. Kusagawa, H. Yuasa, I. Yada, K. Shikano, K. Tanaka, K. Tani, and T. Hayashi Successful Repair of Left Ventricular Aneurysm Associated with Mitral Regurgitation Secondary to Spasm-Induced Myocardial Infarction--A Case Report Vascular and Endovascular Surgery, September 1, 1990; 24(7): 505 - 509. [Abstract] [PDF]

				F. L. Grover, K. E. Hammermeister, C. Burchfiel, and Cardiac Surgeons of the Department of Veterans Aff Initial report of the veterans administration preoperative risk assessment study for cardiac surgery Ann. Thorac. Surg., July 1, 1990; 50(1): 12 - 26. [Abstract] [PDF]

				A. O. Molajo, D. H. Bennett, C. L. Bray, N. H. Brooks, A. N. Rahman, H. Moussalli, J. F. Dark, and B. Faragher Actuarial analysis of late results after closed mitral valvotomy Ann. Thorac. Surg., April 1, 1988; 45(4): 364 - 369. [Abstract] [PDF]

				I. G. Andrade, R. Cartier, P. Panisi, K. Ennabli, and C. M. Grondin Factors Influencing Early and Late Survival in Patients with Combined Mitral Valve Replacement and Myocardial Revascularization and in Those with Isolated Replacement Ann. Thorac. Surg., December 1, 1987; 44(6): 607 - 613. [Abstract] [PDF]

				F. L. Junod, B. J. Harlan, J. Payne, E. A. Smeloff, G. E. Miller Jr., P. B. Kelly Jr., K. A. Ross, K. G. Shankar, and J. P. McDermott Preoperative Risk Assessment in Cardiac Surgery: Comparison of Predicted and Observed Results Ann. Thorac. Surg., January 1, 1987; 43(1): 59 - 64. [Abstract] [PDF]